Multisomatoform disorder: An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care

Kurt Kroenke, Robert L. Spitzer, Frank V. DeGruy, Steven R. Hahn, Mark Linzer, Janet B W Williams, David Brody, Mark Davies

Research output: Contribution to journalArticle

294 Citations (Scopus)

Abstract

Background: For clinical or research use in primary care, the DSM-IV diagnostic criteria for somatization disorder are too restrictive, while the criteria for undifferentiated somatoform disorder are overly inclusive. In this article, we examine the validity of multisomatoform disorder, defined as 3 or more medically unexplained, currently bothersome physical symptoms plus a long (≤2 years) history of somatization. Methods: Data from the Primary Care Evaluation of Mental Disorders Study of 1000 patients from 4 primary care sites were analyzed. The outcomes assessed were 6 domains of health- related quality of life, using the 20-item Short-Form General Health Survey; self-reported disability days and health care use; satisfaction with care; and physician-rated difficulty of the encounter. Results: Multisomatoform disorder was diagnosed in 82 (8.2%) of the 1000 patients who were enrolled in the Primary Care Evaluation of Mental Disorders Study. Compared with mood and anxiety disorders, multisomatoform disorder was associated with comparable impairment in health-related quality of life, more self-reported disability days and clinic visits, and greater clinician-perceived patient difficulty. Conclusions: Multisomatoform disorder may be a valid diagnosis and potentially more useful than the DSM-IV diagnosis of undifferentiated somatoform disorder. Also, because multisomatoform disorder has a large and independent effect on impairment, its diagnosis should not be precluded simply because of a coexisting mood or anxiety disorder.

Original languageEnglish (US)
Pages (from-to)352-358
Number of pages7
JournalArchives of General Psychiatry
Volume54
Issue number4
StatePublished - 1997
Externally publishedYes

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Somatoform Disorders
Primary Health Care
Anxiety Disorders
Mood Disorders
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Quality of Life
Ambulatory Care
Health Surveys
Delivery of Health Care
Physicians
Research

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Kroenke, K., Spitzer, R. L., DeGruy, F. V., Hahn, S. R., Linzer, M., Williams, J. B. W., ... Davies, M. (1997). Multisomatoform disorder: An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Archives of General Psychiatry, 54(4), 352-358.

Multisomatoform disorder : An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. / Kroenke, Kurt; Spitzer, Robert L.; DeGruy, Frank V.; Hahn, Steven R.; Linzer, Mark; Williams, Janet B W; Brody, David; Davies, Mark.

In: Archives of General Psychiatry, Vol. 54, No. 4, 1997, p. 352-358.

Research output: Contribution to journalArticle

Kroenke, K, Spitzer, RL, DeGruy, FV, Hahn, SR, Linzer, M, Williams, JBW, Brody, D & Davies, M 1997, 'Multisomatoform disorder: An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care', Archives of General Psychiatry, vol. 54, no. 4, pp. 352-358.
Kroenke, Kurt ; Spitzer, Robert L. ; DeGruy, Frank V. ; Hahn, Steven R. ; Linzer, Mark ; Williams, Janet B W ; Brody, David ; Davies, Mark. / Multisomatoform disorder : An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. In: Archives of General Psychiatry. 1997 ; Vol. 54, No. 4. pp. 352-358.
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